550 resultados para Bullock, Jeffery.


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La identificación del perfil del Chief Information Officer (CIO) en el entorno empresarial nacional responde a la necesidad de comparar o constatar el rol aplicado en Colombia en relación a la expectativa de la academia y la pertinencia que lleva en un entorno empresarial global. La migración del concepto de CIO y sus definiciones es resultado de la implementación local de prácticas, teorías y estrategias de alto impacto en mercados internacionales. En el presente documento, se profundiza en las competencias estratégicas y roles prácticos que abarca el perfil del CIO como es visto desde aportes académicos y casuísticos en fuentes internacionales líderes en la construcción de conocimiento.

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Objetivo: Evaluar prospectivamente el grado de disfunción sexual en pacientes con incontinencia urinaria de esfuerzo antes y después de la cinta suburetral libre de tensión mediante el cuestionario PISQ-12 validado en español. Materiales y Métodos: Estudio observacional longitudinal de antes y después. Se seleccionaron 60 mujeres sexualmente activas con algún grado de disfunción sexual, entre abril del 2014 hasta marzo del 2015, diagnosticadas con incontinencia urinaria, programadas para colocación de cinta suburetral transobturadora en el Hospital Universitario Mayor Méderi. La mayoría de las pacientes presentaron algún grado de prolapso genital y requirieron corrección quirúrgica asociada a la cinta. Todas las pacientes respondieron el cuestionario PISQ-12 antes y 6 meses después del procedimiento. Resultados: La edad promedio fue 48 ± 4.58 años. El grado de prolapso con mayor frecuencia fue el estadío II del POP-Q 55% (n=33). El 96.7% (n=50) de las pacientes requirieron además de la colocación de la cinta suburetral corrección quirúrgica del prolapso genital. En la evaluación preoperatoria la disfunción sexual se distribuyó así: Severa: 70%, Moderada 18.3% y Leve 11.7%, después de 6 meses postoperatorios se encontró una diferencia estadísticamente significativa del cambio en el grado de disfunción sexual así: Moderada 41.5% y Leve 58.2% donde ninguna paciente quedó clasificada con disfunción severa. Discusión y Conclusión: Las pacientes que presentaron disfunción sexual severa obtuvieron mayor cambio en el grado de disfunción, luego de la colocación de la cinta suburetral.

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Ante el fenómeno de la globalización, el gigante asiático se presenta como un actor fundamental para establecer relaciones económicas, por su reciente ascenso en la jerarquía de poder, su creciente industria demandante de materias primas y su densa población, cuya capacidad de consumo aumenta día a día. Lo anterior le permite a Colombia abrir nuevos mercados que generen un mejoramiento económico y un mayor reconocimiento internacional La presente investigación se desarrolló mediante una metodología cualitativa que abarca la revisión de material bibliográfico, investigaciones realizadas y consulta de documentos oficiales. También se recogen datos estadísticos, fundamentales para soportar los objetivos de este documento y se citan casos de países como Brasil, Argentina y Chile, que constituyen un referente para conocer los procesos que llevan a cabo estas naciones con el gigante asiático relacionados a las importaciones de carne Bovina. La inclusión actual del sector ganadero en los nuevos contextos nacionales e internacionales de competencia por mercados, resulta indispensable para asegurar no sólo la estabilidad sino fundamentalmente la sostenibilidad de la actividad a mediano y largo plazo. Lo anterior debe convertirse en un propósito nacional de los sectores públicos y privados para comenzar a desarrollar, conjuntamente con los gremios; acciones que permitan remover los obstáculos que hoy en día se presentan y promover la modernización de esta actividad. Es pertinente elevar la condición de la producción, comercialización y mercadeo de la ganadería bovina colombiana, además de garantizar niveles de rentabilidad que permitan consolidar la confianza y el impulso necesario para el desarrollo de las inversiones básicas, que la normatividad a nivel de logística y salubridad exige para llegar a nuevos países.

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El objetivo de este estudio fue comparar la eficacia del condicionamiento clásico (CC) y el efecto de mera exposición (ME), en condiciones supraliminales (2000 milisegundos –ms-), sobre la formación de preferencias hacia marcas publicitarias. Se realizó un experimento con diseño intrasujeto, donde se manipuló la variable tratamiento afectivo representada por los dos procedimientos a comparar y se midió la variable dependiente –preferencia hacia las marcas- a través de una tarea de elección forzosa y un diferencial semántico. En el experimento participaron 70 hombres, estudiantes de medicina de la Universidad del Rosario con edades entre 18 y 22 años. El CC se realizó a través de un procedimiento simultáneo y en ambas condiciones la variable independiente se expuso el estímulo 8 veces con una duración de 2000 ms. Los resultados mostraron que los dos procedimientos generaron preferencias en los sujetos, pero no diferencias significativas entre la efectividad de los procedimientos.

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El presente estudio de caso consiste en identificar la incidencia del totalitarismo en la configuración de una política exterior aislacionista, tomando los casos del Tercer Reich y la República Democrática Popular de Corea; se trata de inferir si la incidencia de un régimen totalitario en la configuración de una política exterior aislacionista es directa, en tanto que responde al interés nacional del Estado con el fin de implementar reformas y actos que conlleven al aislamiento de la nación de la comunidad internacional. Para dicho efecto, se utilizará el paradigma realista con el que se pretenderán contrastar las diferencias y similitudes entre los casos estudiados. En consecuencia, en la investigación se utilizarán datos de carácter mixto, en tanto su uso cualitativo y cuantitativo.

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El objetivo principal de esta monografía es identificar cuáles son las razones que justifican las contradicciones entre el discurso y el comportamiento de Estados Unidos en el marco de la Organización Mundial del Comercio, particularmente con relación a prácticas anticompetitivas derivadas del programa de protección a la agricultura del país. Para ello se analizan el interés nacional y los elementos de la seguridad nacional a partir de los cuales éste se ha construido. También se evalúan los procesos de formulación de política comercial y las interacciones entre los representantes políticos, las asociaciones de productores y el sector privado para mostrar como este comportamiento contradictorio corresponde a la legitimización de un interés particular.

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We compared habitat features of Golden-winged Warbler (Vermivora chrysoptera) territories in the presence and absence of the Blue-winged Warbler (V. cyanoptera) on reclaimed coal mines in southeastern Kentucky, USA. Our objective was to determine whether there are species specific differences in habitat that can be manipulated to encourage population persistence of the Golden-winged Warbler. When compared with Blue-winged Warblers, Golden-winged Warblers established territories at higher elevations and with greater percentages of grass and canopy cover. Mean territory size (minimum convex polygon) was 1.3 ha (se = 0.1) for Golden-winged Warbler in absence of Blue-winged Warbler, 1.7 ha (se = 0.3) for Golden-winged Warbler coexisting with Blue-winged Warbler, and 2.1 ha (se = 0.3) for Blue-winged Warbler. Territory overlap occurred within and between species (18 of n = 73 territories, 24.7%). All Golden-winged and Blue-winged Warblers established territories that included an edge between reclaimed mine land and mature forest, as opposed to establishing territories in open grassland/shrubland habitat. The mean distance territories extended from a forest edge was 28.0 m (se = 3.8) for Golden-winged Warbler in absence of Blue-winged Warbler, 44.7 m (se = 5.7) for Golden-winged Warbler coexisting with Blue-winged Warbler, and 33.1 m (se = 6.1) for Blue-winged Warbler. Neither territory size nor distances to forest edges differed significantly between Golden-winged Warbler in presence or absence of Blue-winged Warbler. According to Monte Carlo analyses, orchardgrass (Dactylis glomerata), green ash (Fraxinus pennsylvanica) seedlings and saplings, and black locust (Robinia pseudoacacia) saplings were indicative of sites with only Golden-winged Warblers. Sericea lespedeza, goldenrod (Solidago spp.), clematis vine (Clematis spp.), and blackberry (Rubus spp.) were indicative of sites where both species occurred. Our findings complement recent genetic studies and add another factor for examining Golden-winged Warbler population decline. Further, information from our study will aid land managers in manipulating habitat for the Golden-winged Warbler.

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The Golden-winged Warbler (Vermivora chrysoptera) is currently being considered for protected status under the U.S. Endangered Species Act. The creation of breeding habitat in the Appalachian Mountains is considered a conservation priority for this songbird, which is dependent on extensively forested landscapes with adequate availability of young forest. We modeled abundance of Golden-winged Warbler males in regenerating harvested forest stands that were 0-17 years postharvest at both mid-Appalachian and northeast Pennsylvania regional scales using stand and within-stand characteristics of 222 regenerating stands, 2010-2011. Variables that were most influential at the mid-Appalachian scale were different than those in the northeast region. Across the mid-Appalachian ecoregion, the proportion of young forest cover, i.e., shrub/scrub cover, within 1 km of regenerating stands best explained abundance of Golden-winged Warblers. Golden-winged Warbler response was best explained by a concave quadratic relationship in which abundance was highest with 5-15% land in young forest cover. We also found evidence that the amount of herbaceous cover, i.e., the amount of grasses and forbs, within a regenerating stand positively influenced abundance of Golden-winged Warblers. In northeastern Pennsylvania, where young forest cover is found in high proportions, the distance to the nearest regenerating stand best explained variation in abundance of Golden-winged Warblers. Abundance of Golden-winged Warblers was <1 male per survey when another regenerating stand was >1500 m away. When modeling within-stand features in the northeast region, many of the models were closely ranked, indicating that multiple variables likely explained Golden-winged Warbler response to within-stand conditions. Based on our findings, we have proposed several management guidelines for land managers interested in creating breeding habitat for Golden-winged Warblers using commercial timber operations. For example, we recommend when managing for Golden-winged Warblers in the central Appalachian Mountains that managers should strive for 15% young forest in a heavily forested landscape (>70% forest cover) and cluster stands within 1-2 km of other young forest habitats.

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In January 1992, there was a major pollutant event for the River Canon and downstream with its confluence to the River Fal and the Fal estuary in the west Cornwall. This incident was associated with the discharge of several million gallons of highly polluted water from the abandoned Wheal Jane tin mine that also extracted Ag, Cu and Zn ore. Later that year, the Centre for Ecology and Hydrology (CBH; then Institute of Hydrology) Wallingford undertook daily monitoring of the River Canon for a range of major, minor and trace elements to assess the nature and the dynamics of the pollutant discharges. These data cover an 18-month period when there remained major water-quality problems after the initial phase of surface water contamination. Here, a summary is provided of the water quality found, as a backdrop to set against subsequent remediation. Two types of water-quality determinant grouping were observed. The first type comprises the determinants B, Cs, Ca, Li, K, Na, SO4, Rb and Sr, and their concentrations are positively correlated with each other but inversely correlated with flow. This type of water-quality determinant shows variations in concentration that broadly link to the normal hydrogeochemical processes within the catchment, with limited confounding issues associated with mine drainage. The second type of water-quality determinant comprises Al, Be, Cd, Ce, Co, Cu, Fe, La, Pb, Pr, Nd, Ni, Si, Sb, U, Y and Zn, and concentrations for all this group are positively correlated. The determinants in this second group all have concentrations that are negatively correlated with pH. This group links primarily to pollutant mine discharge. The water-quality variations in the River Camon are described in relation to these two distinct hydrogeochemical groupings. (C) 2004 Elsevier B.V All rights reserved.

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Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation. Design: Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale. Results: A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation. Conclusions: We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

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Uplands around the world are facing significant social, economic and environmental changes, and decision-makers need to better understand what the future may hold if they are to adapt and maintain upland goods and services. This paper draws together all major research comprising eight studies that have used scenarios to describe possible futures for UK uplands. The paper evaluates which scenarios are perceived by stakeholders to be most likely and desirable, and assesses the benefits and drawbacks of the scenario methods used in UK uplands to date. Stakeholders agreed that the most desirable and likely scenario would be a continuation of hill farming (albeit at reduced levels) based on cross-compliance with environmental measures. The least desirable scenario is a withdrawal of government financial support for hill farming. Although this was deemed by stakeholders to be the least likely scenario, the loss of government support warrants close attention due to its potential implications for the local economy. Stakeholders noted that the environmental implications of this scenario are much less clear-cut. As such, there is an urgent need to understand the full implications of this scenario, so that upland stakeholders can adequately prepare, and policy-makers can better evaluate the likely implications of different policy options. The paper concludes that in future, upland scenario research needs to: (1) better integrate in-depth and representative participation from stakeholders during both scenario development and evaluation; and (2) make more effective use of visualisation techniques and simulation models. (C) 2009 Elsevier Ltd. All rights reserved.